Inspection on 23/11/06 for Medora Road, 67

This inspection was carried out on 23rd November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Medora Road, 67 17/02/06

Medora Road, 67 18/10/05

Medora Road, 67 17/02/05

Medora Road, 67 18/11/04

Medora Road, 67 31/03/04

Medora Road, 67 20/01/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Medora Road, 67 67 Medora Road Brixton Hill London SW2 2LW Lead Inspector Ms Rehema Russell Unannounced Inspection 23rd November 2006 10:00 DS0000022742.V311814.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address DS0000022742.V311814.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. DS0000022742.V311814.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Medora Road, 67 Address 67 Medora Road Brixton Hill London SW2 2LW 020 8678 6645 0208 671 5977 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) www.southsidepartnership.org.uk Southside Partnership Mr D Ebrahim Care Home 5 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (5) of places DS0000022742.V311814.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th February 2006 Brief Description of the Service: Medora Road is a residential service for five adults with mental health problems. It is one of a number of homes where the care is provided by a voluntary organisation called Southside Partnership, which provides housing and support services to adults with learning disabilities and mental health problems. The building is owned and maintained by Hexagon Housing Association. Medora Road is a few minutes walk from local shops and buses and a short bus ride away from a busy shopping centre with full community and transport facilities. The house is not suitable for people with mobility restrictions as there are steps and stairs throughout. The ground floor has the lounge/diner, kitchen, 2 bedrooms, a bathroom with toilet and the utility room. The first floor has a toilet, a bathroom with toilet and three bedrooms. The office is on the top floor. There is a small garden at the rear of the house, accessed from the kitchen, and there is unrestricted street parking at the front of the house. Staff liaise closely with the mental health services by use of person centred planning to enable service users to sustain a positive self-image and good mental health. Potential service users would be given a Statement of Purpose, a Service User Guide and verbal information about the home. A copy of the most recent inspection report is kept in the office and in the client’s file in the lounge, and attention is drawn to it at the Tenants’ Meeting. The current charge is £981.33 per week, with no additional charges. DS0000022742.V311814.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 23rd November 2006. There were four service users resident at the home with one vacancy. All four service users were at home at various times during the day and spoke with the inspector. The inspector also spoke with the manager and two support workers, viewed all communal areas of the home and two bedrooms, and examined documentation and records. What the service does well: • • • • • • • Service users’ are consulted on all aspects of life at the home and their rights, views, choices and independence is respected and supported Staff are friendly, approachable and caring and are skilled and knowledgeable about mental health issues The manager’s style is open and inclusive and service users and staff feel able to express their opinions and contribute to the service provided Service users are encouraged and supported to develop daily living skills and their physical, mental and emotional healthcare needs are met Assessments are thorough and care plans are clear and address service users’ changing needs There are high physical standards throughout the home, providing an attractive, comfortable and homely environment The home meets all National Minimum Standards and exceeds several of them • Service users’ comments on the home included: “staff treat me well, I like them, I can talk to them”, “it’s cosy here, the staff are a great team”, “everything is ok, there are no problems”, “staff are helpful and efficient and the facilities are good” and “staff listen”. What has improved since the last inspection? One service user has moved on to more independent accommodation in the community, having been supported and encouraged by staff to develop their confidence and daily living skills. No requirements and only one recommendation arose from the previous inspection. The recommendation was for the manager to continue to work with issues around the level of smoking in the lounge and non-smokers’ needs, and this had been done. Service users have agreed to reduce the level of smoke in the lounge by smoking out in the garden, unless the weather is very poor or it is late at night. The fan in the lounge has also been repaired and is now functioning properly. DS0000022742.V311814.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. DS0000022742.V311814.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000022742.V311814.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 4 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There is a thorough assessment process which ensures that prospective service users’ individual aspirations and needs are assessed, and that they have all the information they need to make their choice. Potential service users are given several opportunities to visit and “test drive” the home and meet with service users and staff. EVIDENCE: At the time of the inspection the home had just assessed a potential service user to fill the current vacancy, and these papers were checked. They evidenced a clear and thorough assessment process. The Community Care assessment of need and a new Care Programme Approach summary had been obtained. A referral application form had been sent to and filled in by the potential service user’s social worker and contained all relevant information, including areas which the future care plan would need to address. The home had filled in it’s own 10 page referral questionnaire/assessment form, which covers all relevant areas such as support, cultural and religious needs, mental health, medication, money/benefits, physical health, education/employment and relationships. This referral questionnaire is filled in by the two members of staff, in this case the manager and deputy, in discussion with the person being assessed. It has been devised in such a way that the potential service user is fully involved in the process, is given full details of life at the home and time to ask questions, make enquiries and give their opinion on their own DS0000022742.V311814.R01.S.doc Version 5.2 Page 9 needs and aspirations. It also has reminders throughout that ensure the interviewers covers all important aspects of living at the home, such as an outline of the service offered at the home, the importance of partnership between service users and staff, any environmental conditions such smoking restrictions, and the expected length of stay. If the potential service user is female, the manager ensures that one of the two members of staff undertaking the assessment is also female to ensure sensitivity and privacy for personal health questions. This is good practice. Potential service users are given several opportunities to visit and assess the home. The current potential service user had visited the home with the Care Co-ordinator, been given information, shown around the home, and met with staff and service users. They had been given the opportunity to speak with the home’s service users privately on their own and had also been introduced to the local area. As part of the assessment, the potential service user will also be offered other trial opportunities, such as an overnight/weekend stay. DS0000022742.V311814.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Each service user has an individual care plan which reflects their assessed and changing needs. Service users are encouraged and supported to make decisions about all aspects of their lives. Service users are consulted on, and participate in, all aspects of life in the home and are supported to take risks as part of an independent lifestyle. EVIDENCE: Two care plans were examined. They were found to be thorough, clearly written, well laid out and containing all necessary information. Each care plan has at least 3 care components which each state the need, short term goal and long term goal and then outline the action needed, the person responsible for this and the evaluation date. Each care plan component is evaluated monthly and signed and dated by the service user and the key worker. Detailed daily progress reports are kept, which are informative and give a good overall picture of each service user’s health, social interaction, indoor and outdoor activities and relevant incidents in their lives. In addition, care plan files also include a cultural needs assessment form and a Life Plan, both of which the DS0000022742.V311814.R01.S.doc Version 5.2 Page 11 service user completes. The Life Plan has three sets of goals: 1-3 months, 1 year and 5 year goals. A service user spoken with confirmed that his 1-3 months and 1 year goals had been achieved, and that he was currently working through his 5 year goals. The Life Plan is reviewed annually. Care files also have a programme of activities, detailed and clear key worker evaluation meetings, and minutes of CPA review meetings. Observation and verbal evidence throughout the inspection showed that service users are encouraged and supported to make as many decisions as possible about all areas of their lives. The manager and staff were very protective of service users’ rights to privacy and confidentiality, and their right to choose occupations, activities and lifestyles that suit them. When service users indicate that they may wish to make choices that staff know may be detrimental to their welfare, for example to stop taking medication, then staff provide them with information, assistance and support that may help them to make a healthier decision. This would include involving external professionals as appropriate. There is information of how service users may contact external independent advocates on the notice board and in addition staff have given each service user an individual copy of the leaflet for reference. In the previous year staff arranged for an independent advocate to visit the home and speak directly about the service offered. All service user handle their own finances, two completely independently. Staff only retain the food allowance for the other two service users, who are given the full amount weekly, or when they request it. There is an expectation that all service users participate in the day to day running of the home, and staff ensure that service users are given every opportunity to do this. Tenants Meetings are held monthly, each with an agenda and often with minutes taken and written up by service users. Copies of minutes are kept in a file in the lounge sideboard so that a record of decisions and agreements is readily accessible to all service users. Minutes evidenced that service users discuss, comment upon and make suggestions and decisions about all aspects of life at the home, including health and safety, household chores, social activities, Southside Partnership policies and procedures, decoration and refurbishment, new service user referrals and improvements to the service. Staff also give service users information about local and national events, health issues, maintenances issues with updates on action, and resources such as the Fanon centre for people of Caribbean descent. Service users are given the opportunity to be involved in the recruitment of new staff by devising questions for applicants and making decisions on the suitability of answers given. They are paid for their contribution, which further validates their participation. Service users also meet with applicants and have the final choice on who is selected. Documentary and verbal evidence, plus observation on the day of inspection, demonstrated that service users are encouraged and supported to make independent decisions and to take responsible risks in their daily lives. DS0000022742.V311814.R01.S.doc Version 5.2 Page 12 Examples were given of various circumstances where staff were sensitive to service users’ vulnerabilities, for example in the community, and made suitable assessments to ensure their safety and wellbeing. Risk assessments were seen on files. These were well thought out, detailed and thorough, outlining the means of achieving the objective, decisions and action to be taken, and the methods of monitoring to be used. All assessments were signed by the service user and support worker, and were regularly reviewed. DS0000022742.V311814.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users take part in age, peer and culturally appropriate activities and are as part of the local community as they choose to be. Service users have appropriate personal and family relationships, and their rights and responsibilities are respected and recognised in their daily lives. Service users are advised and supported to choose a healthy diet and to enjoy their meals and mealtimes. EVIDENCE: One service user attends college regularly, uses the public library regularly and attends a drop in centre weekly. Another service user has attended college since being at the home and obtained paid employment, and has plans to undertake further education when the current period of ill health is over. Two service users are not interested in attending college or trying to obtain employment but make use of community facilities such as shops, cafes, banks and post offices. All service users use the local community for cafes, shopping, banking, cinema, transport, and health services. DS0000022742.V311814.R01.S.doc Version 5.2 Page 14 Care plans and discussions with service users and staff showed that staff support and encourage service users to maintain family and friendship links according to their individual choice and appropriateness. The regularity of visits varies, from weekly to twice annual visits. Service users confirmed that they are able to choose whether to visit friends and family or to invite them back to the home. Staff also encourage service users to bring boy/girlfriends for home visits, just as they would in their own homes. All service users have keys to their rooms, some choosing to keep their rooms locked whenever they are not in them and others choosing to lock them only when going out of the home. Staff were observed to interact with service users in a friendly and respectful way throughout the inspection, to exercise patience when service users were reluctant to undertake their household chores and to always acknowledge service users’ rights to exercise choice and their own decision making. Routines are very flexible at the home, with one service user regularly choosing not to get up until late in the morning, and all service users observed to eat and drink at times that suited themselves. One service user told the inspector that they didn’t think they “would have survived this long” without the kindness and support given to them by staff. Another said that they felt able to make all their own decisions and choices, apart from those taken out of their hands by external authorities. All service users are responsible for their own shopping and cooking, but staff will support them if appropriate or requested. Service users decided that they do not wish to have a group meal on Sundays, and Tenants’ Meeting minutes also showed that they have chosen not to have a shared Christmas in regard to shopping and activities. As service users generally lead independent lives they often eat out or are not around at mealtimes so staff are not able to monitor comprehensively what service users eat, although records are kept wherever possible. Records seen showed that service users are very individual in the range of foods eaten, one service user tending to eat main meals out and another eating culturally appropriate foods. Staff offer support and advice about healthy eating. There are healthy eating guidelines in the lounge, where they are easily accessible, and staff arranged for a dietician to visit the home and speak with service users earlier in the year. Throughout the inspection service users were observed to use the kitchen freely and to prepare food and snacks of their choice. DS0000022742.V311814.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staff provide sensitive support in the way that service users require and prefer. Staff are diligent in ensuring that service users’ physical and emotional health care needs are met, and operate a very thorough medication system that protects and safeguards service users. EVIDENCE: Service users do not require staff to provide personal physical care but may require prompting to carry out their personal care regularly or to an adequate standard. Evidence from speaking with staff indicated that this is done sensitively, ensuring that service users’ privacy, dignity and independence is respected. Staff are fully aware of the different needs that may arise for people from minority ethnic groups and there was evidence of cultural assessments in care files. Service users were age appropriately dressed and their appearance reflected their own choices and personalities. If service users are feeling low or having a period of poor mental health, staff will support and encourage them to maintain reasonable physical health and personal hygiene, enlisting the help of outside professionals where this becomes appropriate or necessary. One service user described the support they are currently receiving from staff around their temporary inability to carry out their household chores fully and their decision to voluntarily request external professional help. DS0000022742.V311814.R01.S.doc Version 5.2 Page 16 Documentary and verbal evidence indicated that service users’ care and health needs are monitored and responded to thoroughly and appropriately. The manager described how staff had been diligent in observing and following up behaviours in a service user which led to a serious condition being diagnosed and treated. Staff supported the service user sensitively throughout the treatment, encouraging the service user to attend appointments by adding incentives to the day, such as having a meal out. Similarly, staff have succeeded in persuading another service user to ask for external professional help voluntarily and are in daily contact with the required services to facilitate this. Documentary evidence showed that staff support service users to access the full range of community health checks, such as the optician, dentist, Community Psychiatric Nurse, chiropodist and general practitioners. All service users belong to the same GP practice but each have different doctors. Care plans confirmed that staff work closely with external professionals, whom they contact for advice as appropriate. The storage, administration and recording of medication was not checked as the Lambeth NHS Pharmacist had undertaken their annual inspection of the home during the week previous to this inspection. The pharmacist’s report was seen. It noted that “staff show a good understanding of medication management” and concluded that the home demonstrated “Excellent medication management with no issues of concern”. DS0000022742.V311814.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service user views are listened to and acted upon and service users are protected from abuse, neglect and self-harm. EVIDENCE: There is a clear, detailed, easily understood and effective complaints procedure. A copy is displayed on the notice board so that it is easily accessible to service users, and a further copy is kept in a complaints file in the lounge. No formal complaints had been received by the home for over a year. Service users confirmed that they knew how to make a formal complaint but had none and would speak directly to the manager and staff if they had any concerns. Staff have discussed the use of mental health advocacy services with all service users and literature about how to contact the service is displayed on the notice board. All staff have had abuse training, both during induction and then as a separate external course. In addition, the manager, deputy and two support workers have undertaken “Welcoming Diversity” training. Staff spoken with were aware of the many different forms of abuse and the procedures to be followed should abuse be suspected. Staff also demonstrated understanding of how to deal with verbal or physical aggression and cited a recent example, which had been dealt with sensitively and safety with the correct procedures followed. DS0000022742.V311814.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29, 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users live a homely, comfortable and safe environment. Bedrooms suit their needs and lifestyles and promote independence. Toilets and bathrooms provide privacy and meet individual needs. No specialist equipment is required but there are handrails in case of need. There is sufficient shared space in the home and the home is clean and hygienic. EVIDENCE: The home’s premises and location are suitable for its stated purpose, accessible, safe and well maintained. It is an ordinary end of terrace house that is in keeping with the surrounding houses and therefore not distinguishable as a care home. It has three floors and no lift and so is not suitable for people with mobility problems. It is attractively decorated, fitted and furnished and very homely throughout. The home is located close to local community amenities and transport and is also a short bus ride from a major shopping and transport centre which has full community facilities including a main library, large recreation centre, cinema etc. There are three communal areas in the home, the lounge/diner, the kitchen and the garden, and all three are attractive and well maintained. The lounge DS0000022742.V311814.R01.S.doc Version 5.2 Page 19 has a leather sofa and chairs, coffee table, fish tank, plants, sideboard dresser, music system, games, books, widescreen television with DVD and digibox, large mirror, clock, positive images, and standard lamp. The décor and match of carpet with sofa makes the room particularly attractive and comfortable. There is a dining table and chairs of good quality near the kitchen. The sideboard dresser has an area where the tenants meeting file, tenants charter, complaints information, policies for consultation with service users and directory of local services and facilities are kept, so that all of these are readily accessible to all service users. As most service users smoke there is a fan and an air purifier in the lounge to try to keep the air reasonably clean and enable non-smokers to feel comfortable and able to use the lounge. Service users have recently agreed to a policy whereby they undertake to smoke outside in the garden, rather than the lounge, unless the weather is very poor or it is late at night. To further facilitate this, the manager is currently obtaining quotes for having a shelter built in the garden. The garden is attractive and well maintained with good quality garden furniture. The kitchen was refurbished last year and is well laid out with fixtures and fittings of high quality. Each service user has their own cupboard for dry foods for which they have a key. They share space in the two fridge/freezers. Service users and staff keep the kitchen clean and on the day of inspection it was found to be very clean and tidy. There is a laundry room on the ground floor which is suitably equipped and in which any hazardous household substances are kept locked in a cupboard. The home has a bathroom with toilet on the ground floor and a separate toilet and bathroom on the mezzanine/first floor. This proportion of 2 toilets and 2 bathrooms to 5 service users exceeds minimum standards. All three rooms were well fitted and equipped, and although none of the service users require aids and adaptations, the rooms have been fitted with support rails and bars should they be needed at any time. Service users are expected to keep these areas clean as part of their shared household chores, with staff prompting and support as necessary, and all three rooms were found to be clean and hygienic with no unpleasant or offensive odours. Two bedrooms were seen. They were well furnished, fitted and decorated and were personalised according to the individual service user’s preferences and interests. Service users said that their rooms were warm and comfortable and that they were happy with them. They were observed to spend time both in the lounge and in their bedrooms at choice during the day. All areas of the home seen on the day of inspection were tidy, clean, and hygienic. DS0000022742.V311814.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users are supported by competent and qualified staff and an effective staff team. The Registered Provider operates a thorough recruitment procedure which protects and safeguards service users, and a comprehensive induction and training programme which ensures that service users’ needs are met. EVIDENCE: The inspector spoke with and observed the manager and two support workers at the home. All demonstrated sensitivity, approachability, good communication skills, a comprehensive knowledge of mental health issues and a good understanding of individual service users’ needs, interests and behavioural characteristics. Staff are very committed to service users’ rights, choices and self-determination, and this was evident in the way they spoke and interacted with service users. Service users spoken with said that they felt comfortable with staff, liked them and felt they could talk to them. Examples were also given of where staff had approached mental health problems and potentially difficult situations with sensitivity and tact. The home has exceeded the 2005 NVQ Level 2 training recommendation, with two of the three support workers having NVQ Level 3 qualification. The staff team is mixed in terms of gender and race, reflecting the cultural and gender composition of service users. The team is also stable, with very low use of agency staff, and therefore DS0000022742.V311814.R01.S.doc Version 5.2 Page 21 provides good continuity of care. Monthly, minuted staff meetings are held, at which staff said they feel able to express their views and contribute to team working. Recruitment files are kept at the Registered Provider’s head office and could not therefore be checked at this inspection. However, speaking with very recently recruited members of staff at various other homes run by the Registered Provider has evidenced that there is a thorough recruitment policy and procedure, which adheres to equal opportunity principles and which safeguards and protects service users. The involvement of service users in recruitment at this home has been described in Standard 8 above. All staff undergo an induction and training programme on commencement of employment. Initial induction covers all of the basic policies and procedures at the home, including medication and health and safety, plus training in fire safety, food hygiene, infection control, basic first aid and mental health. From then on individual training needs are identified through supervision, where staff are encouraged to undertake self-development by suggesting areas of training and skills development for themselves. During their first working week at the home a new support worker shadows experienced members of staff, and after that they may undertake a shift on their own, supported and monitored by the manager/deputy. The Registered Provider runs a very well organised and comprehensive training programme, providing individual training profiles for staff and regular reminders to homes when refresher courses are due. Staff profiles showed that staff have undertaken a full range of relevant training during the year including advanced supervision, financial management, adult abuse, the Disability Discrimination Act, how to deal with difficult people, fire safety, steps to management, assertiveness, manual handling, how to deal with depression and welfare benefits. DS0000022742.V311814.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 41, 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users benefit from a well run home and the ethos, leadership and management approach of the home. Service users views underpin all aspects of life at the home including self-monitoring, review and development. Record keeping is thorough and confidential. The health, safety and welfare of service users are promoted and protected. EVIDENCE: The Registered Manager has many years experience with the client group and in management. He has NVQ Level 4 in management and care and the Registered Manager’s Award. He has also undertaking many relevant training courses, both internally and externally, and is fully qualified, competent and experienced to run the home. The processes of managing and running the home are open and transparent and the manager’s style is open, positive and inclusive. Staff said that they felt part of a team and supported in their work, and were able to express their DS0000022742.V311814.R01.S.doc Version 5.2 Page 23 views in team meetings and supervision. Service users also said that they felt able to express themselves freely and it was evident from observation that they have a supportive, friendly and respectful relationship with the manager. Service users’ views underpin all self-monitoring, review and development at the home. Observation and verbal evidence from staff and service users indicated that service users’ views are sought on all aspects of life at the home, informally on a day to day basis and formerly via the monthly Tenants Meetings. Minutes in the Tenants Meeting File showed that each meeting has a staff member present with minutes taken by a service user. Areas covered include health and safety, household duties, social activities, Registered Provider policies for consultation, inspection reports, choices for decoration and flooring and service user involvement. Suggestions and issues raised by service users are actioned and carried forward for feedback to the following meeting. The manager has carried out the annual service users’ survey and was in the process of analysing and publishing the results at the time of the inspection. The surveys indicated that service users are very happy with the service received from staff and the facilities provided at the home. The Registered Provider carries out monthly (Regulation 26) monitoring reports that are very detailed and comprehensive and always include consultation with service users, and the Provider also runs a Service Users’ Committee, which service users from this and all other homes can choose to attend, and whose minutes are discussed at tenants meetings. The home now has an annual business plan which arises from the aims and objectives of the provider organisation. A range of records and documentation was seen during the inspection and all records were thorough, well kept and up to date. All care plans and confidential information are kept in locked filing cabinets in the office at the top of the house. The following health and safety working practices were checked and found to be in good order: • • • • • • • • • • • Training in fire safety, food hygiene, infection control, first aid, and moving and handling Understanding and storage of COSHH Daily health and safety checks Weekly health and safety checks Daily security checks Window restrictors Water and fridge temperatures Weekly Legionella water testing Weekly fire point checks Fire drills (3 monthly) Health and safety risk assessments DS0000022742.V311814.R01.S.doc Version 5.2 Page 24 • • • • • • • Accidents and incidents records Annual gas safety certificate Local authority food hygiene visit of September 2005 (no recommendations) LFEPA (fire) visit of May 2006 (no recommendations) Fire alarm testing Annual small electrical appliances test of August 2006 Financial audit of September 2006 The 5 yearly electricity safety certificate had expired in May and the manager undertook to inform the Registered Provider so that a visit could be arranged. DS0000022742.V311814.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 4 3 X 4 4 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 4 27 4 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 4 33 3 34 3 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 4 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 4 X 3 4 4 X 3 3 X DS0000022742.V311814.R01.S.doc Version 5.2 Page 26 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations DS0000022742.V311814.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection SE London Area Office Ground Floor 46 Loman Street Southwark SE1 0EH National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI DS0000022742.V311814.R01.S.doc Version 5.2 Page 28 DS0000022742.V311814.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!